What Is the Current Standard of Care for Anti-HER2 Neoadjuvant Therapy in Breast Cancer? - Cancer Network. ABSTRACT: Neoadjuvant treatment with a sequential anthracycline-taxane–based chemotherapy in combination with trastuzumab (Herceptin) is currently a preferred therapy for patients with HER2-positive breast cancer. This approach is based on the higher pathologic complete response (pCR) of 40% seen with the addition of trastuzumab, compared with a 17% pCR with chemotherapy alone. The pCR can be increased to 75% with dual HER2-receptor blockade and chemotherapy.
Higher pCR rates are found in hormone-receptor–negative tumors. Patients with a pCR after chemotherapy and trastuzumab showed a significantly better outcome compared with those who did not have a pCR. The neoadjuvant approach toward breast cancer therapy, initially developed to convert primary inoperable locally advanced tumors, is today considered a standard option, especially for patients with triple-negative or HER2-positive disease.
Two smaller studies have recently reported comparable results. Can We Abandon Anthracyclines for Early Breast Cancer Patients? - Cancer Network. Abstract: Anthracycline-containing regimens improve disease-free and overall survival of patients with early breast cancer, but the toxicity, especially the cardiotoxicity, of the anthracyclines make them unattractive in the adjuvant setting. Two large, randomized trials, one in unselected patients and one in those with HER2-positive tumors, suggest that a taxane combination without an anthracycline might be just as effective as more traditional regimens. These and other studies also suggest that the anthracyclines might reasonably be used only for those with more aggressive forms of breast cancer, as defined by molecular markers.
The results of these studies are provocative but insufficient to justify the conclusion that anthracyclines can be either abandoned or used only for a very select group of patients. The anthracyclines doxorubicin and epirubicin are among the most effective cytotoxic treatments developed for the treatment of breast cancer. Results of BCORG Trial 006. The Distinctive Nature of HER2-Positive Breast Cancers. British Journal of Cancer - Beyond trastuzumab: novel therapeutic strategies in HER2-positive metastatic breast cancer. 2 Leading Breast Cancer Researchers Discuss Emerging Anti-HER2 Therapeutics. Dennis Slamon, MD, PhD Director, Clinical/Translational Research Director, Revlon/UCLA Women’s Cancer Research Program Chief, Division of Hematology/Oncology Jonsson Comprehensive Cancer Center University of California, Los Angeles Carlos L.
Arteaga, MD Director, Breast Cancer Research Program Associate Director, Clinical Research Professor of Medicine and Cancer Biology Vanderbilt-Ingram Cancer Center Nashville, TN Dennis Slamon, MD, PhD, played a leading role in the research that resulted in the development of Herceptin in the 1990s and remains involved in research into targeted therapies.
Carlos L. Arteaga, MD, focuses on the role of signaling by oncogenes in the progression of breast tumor cells and molecular therapies in breast cancer. What role does HER2 play in normal cells and in the development of cancer? How important is HER2 dimerization in the development of cancer? What are HER2 dimerization inhibitors, and how important is this therapeutic class? New 'Achilles' Heel' In Breast Cancer: Tumor Cell Mitochondria. Breast Cancer Vaccine Begins Phase III Trial : Family Practice News. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial : The Lancet Oncology.